目的:探讨睾酮治疗骨髓增生异常肿瘤细胞减少症的潜力,并探讨性腺功能减退症与血液系统恶性肿瘤之间的联系。
方法:介绍了1例中危骨髓增生性肿瘤和性腺功能减退症患者的睾酮替代疗法。睾酮,前列腺特异性抗原,在治疗开始前和治疗后3个月检查促红细胞生成素水平.随时间监测血液计数。随后,文献综述了睾丸激素在骨髓增生异常肿瘤中的使用以及血液系统恶性肿瘤中性腺机能减退的患病率。
结果:患者经睾酮治疗后贫血持续改善,并报告其虚弱和疲劳的主观改善。即使在无法检测的后续促红细胞生成素水平下,这种改善也会发生。他的重复前列腺特异性抗原水平仍然很低,而睾酮水平显着改善。文献综述显示睾酮在治疗骨髓增生异常肿瘤相关的血细胞减少中的阳性应答率。并显示血液系统恶性肿瘤中性腺功能减退症的发生率较高。
结论:我们的综述表明,睾酮在低风险和中等风险骨髓增生性肿瘤中的应用未得到充分开发,并具有作为未来治疗药物的巨大潜力。在仔细考虑风险和收益之后。此外,骨髓增生异常肿瘤中性腺功能减退的发生率及其对骨髓增生异常肿瘤中血细胞减少加剧的潜在影响值得进一步研究.
OBJECTIVE: To explore the potential of testosterone therapy in managing cytopenias in myelodysplastic neoplasm and investigate the link between hypogonadism and hematologic malignancies.
METHODS: A case of a patient with intermediate-risk myelodysplastic neoplasm and hypogonadism treated with testosterone replacement therapy is presented. Testosterone, prostate specific antigen, and erythropoietin levels were checked prior to therapy initiation and 3 months after. Blood counts were monitored over time. This is followed by a literature review of testosterone use in myelodysplastic neoplasm and the prevalence of hypogonadism in hematologic malignancies.
RESULTS: The patient showed sustained improvement in anemia with testosterone therapy and reported subjective improvement in his weakness and fatigue. This improvement occurred even in the setting of an undetectable follow up erythropoietin level. His repeat prostate specific antigen levels remained low, while testosterone levels showed marked improvement. The literature review demonstrated positive response rates for testosterone in treating myelodysplastic neoplasm-related cytopenias, and showed a higher incidence of hypogonadism in hematologic malignancies.
CONCLUSIONS: Our review suggests that the use of testosterone in low and intermediate-risk myelodysplastic neoplasm is underexplored and poses to have significant potential as a future therapeutic agent, after careful consideration of risks and benefits. In addition, the incidence of hypogonadism in myelodysplastic neoplasm and its potential impact on exacerbating cytopenias in myelodysplastic neoplasm warrants further investigation.